Autistic youth are at increased risk for needing emergency services compared to their non-autistic peers. While research has begun to explore the nature of emergency service use in this group, researchers have not yet assessed important individual-, family-, and community-level factors that may be associated with these encounters. This study aimed to address this gap in the field via a mixed methods design by characterizing families of autistic children who have utilized emergency services, examining factors accounting for significant differences in service utilization, and exploring family experiences and satisfaction with emergency service encounters. 77 caregivers of autistic individuals who endorsed current child challenging behavior completed measures assessing child, family, and community variables. 38 caregivers had used emergency services in recent years; a subset of caregivers (n = 8) completed interviews about their experiences with emergency services. Bivariate analyses and a multivariate analysis of variance were conducted with individual, family, and community variables to determine group differences for families with and without recent emergency service use. Child psychiatric co-occurring conditions (F(3, 70) = 17.40, p < .001, partial η2 = 0.20) and child aggressive behavior (F(1, 72) = 11.22, p = .001, partial η2 = 0.14) were significantly associated with emergency service use. In qualitative interviews, caregivers described a range of facilitators and barriers to emergency care. These findings shed light on clinical characteristics that may be important for developing prevention efforts and indicate a significant need for broad reform at the intersection of emergency care and autism services.

Autism is a heritable neurodevelopmental condition marked by impaired social interaction, repetitive behavior, and co-occurring conditions. Sleep disturbances are common in autism. This study uses low-cost wearable devices to compare sleep, physical activity, and circadian behavior in autistic adults and their non-autistic relatives. We recruited 318 autistic individuals and 130 family members, collecting accelerometer data over 3 weeks (8249 days). Using a data-driven approach, we identified actimetry-derived features associated with autism. We examined 308 traits using the elastic net algorithm and linear mixed effects regressions. We identified 52 actimetry measures associated with autism (area under the curve: 0.812; confidence interval: 0.761-0.862), validated in a test set (area under the curve: 0.756; confidence interval: 0.700-0.813). Both mean and day-to-day variability in several measures (e.g., time spent sedentary, total light physical activity) were associated with autism. In autistic individuals, reduced physical activity during wake was more strongly associated with shorter sleep time than in non-autistic relatives (likelihood ratio: 41.6; p = 1.13e-10). Reduced physical activity in autistic individuals was linked to increased social impairment, as measured by the Social Responsiveness Scale. Long inactivity periods and lower physical activity levels were associated with autism, correlating with less sleep and later sleep onset. Interventional studies are needed to explore if improving sleep and physical activity can improve the quality of life for autistic individuals.Lay AbstractAutistic individuals frequently report problems with their sleep, though what aspects of sleep are most affected is not well understood. In this study, we recruited 318 adult autistic participants without intellectual disability and 130 of their non-autistic family members to measure their sleep, physical activity, and daily routines. Study participants wore accelerometer-based wrist-worn devices over 3 consecutive weeks to record their movement and activity. In total, 154 distinct physical activity, sleep, and behavioral traits were identified from the recordings, 52 of which were found to associate with autism. Many of these traits were related to physical activity, where autistic individuals were more likely to be less active for longer periods and have lower overall physical activity levels. Long periods of inactivity also associated with less sleep, with a stronger association in those with autism. For example, for every hour of inactivity, autistic participants had on average ~23 min less of sleep compared to ~17 min in their family members. Autistic individuals with lower levels of physical activity showed higher social impairment as measured by the Social Responsiveness Scale. Overall, lower physical activity may impair sleep and worsen the core features of autism. Interventional studies aimed to increase physical activity may improve the quality of life of autistic individuals.

Sex differences in internalising problem trajectories of autistic and non-autistic youth across childhood and adolescence.

A brief report: Caregivers of autistic individuals and nonautistic peers’ perceptions of a community-based inclusive basketball program

Autism is a neurodevelopmental condition characterized by persistent communication challenges, often compounded by social anxiety. Although differences in perspective-taking, cognitive flexibility, and social motivation have been implicated in these challenges, their influence on live interpersonal interactions remains unclear. In this study, we quantitatively examined how autistic and non-autistic individuals with varying levels of social anxiety adapted their communication during experimentally controlled interactions with two ostensibly distinct partners-a child and an adult-both portrayed by the same role-blind confederate. Autistic participants were equally motivated and capable as non-autistic participants in adjusting their communication to stereotypical assumptions about a partner's abilities, spontaneously using greater emphasis when addressing the presumed less capable child. However, they were less likely to modify these stereotype-driven behaviors in response to interaction-based evidence of partners' equal competence. While non-autistic participants dynamically adapted their communication to treat both partners equivalently, autistic participants maintained their stereotype-driven adjustments throughout the interaction. Preregistered analyses further linked non-autistic individuals' adaptive responses to early social exposure, a developmental factor not observed in autistic participants. Together, these findings highlight a core interactional capacity, shaped by early social experiences and operating on interaction-based evidence, as central to understanding communication challenges in autism.Lay abstractEveryday communication can be challenging for autistic individuals, particularly when social anxiety is involved. Research suggests that differences in understanding and adapting to others may contribute to these challenges, but it remains unclear whether and how these differences affect real-time interactions. This study invited autistic and non-autistic participants with varying levels of social anxiety to interact online with two "partners." One partner was introduced as a child and the other as an adult, although in reality the same actor played both roles without knowing which role he was assigned. All participants initially emphasized their communication more with the presumed child, whom they assumed was less capable. Over time, however, non-autistic participants adapted their approach, treating both partners equally as they gathered evidence that the child was just as competent as the adult. In contrast, autistic participants continued to treat the child as less capable throughout the interaction. Moreover, non-autistic participants who adapted more quickly tended to have experienced greater early social exposure in daycare, a relationship that was not observed in autistic participants. These findings suggest that while autistic individuals are willing and able to adjust their communication based on initial assumptions about others, they are less likely to revise these adjustments in response to evidence of a partner's actual understanding during interaction, a skill that appears to develop differently for them from an early age.

Strong daily living skills (DLS) are associated with positive outcomes. Prior studies have documented intellectual quotient (IQ)-DLS discrepancies in autistic individuals with average or higher cognitive abilities. Little work in this area includes individuals with co-occurring intellectual disability (ID) or examines IQ-DLS discrepancies at the level of DLS subdomains (i.e., Personal, Domestic, and Community skills). This study examined trajectories of IQ-DLS discrepancies from ages 2-25 in autistic individuals with ID. A total of 127 individuals from a well-characterized longitudinal cohort with verbal IQ < 70 at age 9 were included. IQ-DLS discrepancy scores were calculated by subtracting DLS AEs from nonverbal mental age (NVMA) estimates. Group-based trajectory modeling identified IQ-DLS discrepancy trajectory groups for the DLS domain and Personal, Domestic, and Community subdomains. One-way ANOVA and chi-square analyses were used to compare trajectory groups on demographic and phenotypic characteristics. Two DLS domain discrepancy trajectory groups emerged: IQ > DLS (cognitive abilities exceeded DLS) and IQ < DLS (DLS exceeded cognitive abilities); most participants (78%) were in the IQ > DLS group. An additional group, IQ = DLS (cognitive abilities and DLS were commensurate), emerged in each of the DLS subdomains, for a total of three trajectory groups. Within DLS subdomains, approximately 80% of participants were in either the IQ = DLS or the IQ < DLS trajectory group. In other words, examining scores at the DLS domain-level indicated most participants had cognitive abilities that exceeded DLS, but subdomain scores indicated most participants had DLS that equaled or exceeded cognitive abilities. These results challenge the notion that autism is usually associated with weaknesses in DLS compared to IQ. At the subdomain level, 80% of participants had DLS commensurate with or stronger than their cognitive abilities, indicating domain-level scores may obscure important variability in daily functioning. This work highlights the importance of including autistic individuals with ID in research; patterns observed in samples without ID may not be generalizable.

Autistic adults often face co-occurring depressive symptoms. While previous studies have focused primarily on depression in children with autism, this study aims to investigate the factors associated with depressive syptoms in autistic adults. By examining a broader range of variables including sociodemographic factors and autistic traits like sensory sensitivity and restricted and repetitive behaviors, we seek to gain a more comprehensive understanding of the elevated levels of depression within this population. This quantitative study utilized a cross-sectional design. Two hierarchical regression analyses were conducted. The first analysis included all participants (N=438), focusing on demographic factors such as age, gender, income, in the first model and autistic traits such as repetitive behaviors, and depressive symptoms in the second model. The second analysis included a reduced sample (N=305) that additionally incorporated sensory sensitivity data. Older age, lower income, and a greater number of co-occurring psychosocial problems were significantly associated with higher levels of depressive symptoms. Our research, unique by its large sample of adults with autism and innovative exploration of potential factors of influence, offers valuable insights into the unique challenges faced by autistic adults. Our findings highlight the difficulty older autistic individuals may encounter in accessing support services primarily designed for younger populations. Moreover, co-occurring problems and lower income can exacerbate these challenges, leading to instability and limited access to resources. These results underscore the urgent need for societal inclusion and tailored support systems to promote the mental well-being of autistic adults.

Existing literature suggests that differences between autistic and non-autistic people in emotion recognition might be related to differences in how these groups experience emotions themselves. Specifically, autistic individuals may show differences in the consistency of emotional experiences, the ability to distinguish between emotions, and/or their semantic understanding of emotions. In this study, we empirically tested this claim by (1) investigating whether autistic and non-autistic adults differed in the consistency and/or differentiation of their emotional experiences, and their understanding and differentiation of emotion concepts after controlling for alexithymia, and (2) assessing the contribution of these emotional abilities to emotion recognition. To this end, a total of 58 autistic and 59 non-autistic individuals, matched on age, sex, and non-verbal reasoning ability, completed a series of validated questionnaires and computer-based emotion tasks. We found no group differences in emotional consistency, emotion differentiation, and understanding or differentiation of emotion concepts after controlling for alexithymia. For non-autistic people, the ability to differentiate one's own emotions contributed to enhanced emotion recognition. Although having more differentiated emotion concepts (indirectly) contributed to elevated emotion recognition for non-autistic people, having a more precise understanding of emotion concepts contributed to emotion recognition for autistic people. Our findings demonstrate that there are differences in the psychological mechanisms involved in autistic and non-autistic emotion recognition. The results of the current study pave the way for future systems to help both autistic and non-autistic people to more accurately recognize emotional facial expressions.

Misophonia is the adverse emotional reaction to everyday sounds (e.g., chewing or pen clicking). Since atypical sensory experiences are a key feature of autism, we investigated whether autistic individuals are more liable for experiencing misophonia symptoms. In addition, we explore the contribution of sensory sensitivity to misophonia symptoms in autism. Autistic adults (N = 1050) filled out the Amsterdam Misophonia Scale-Revised (AMISOS-R), the Autism Spectrum Quotient (AQ-28), and the Sensory Processing Questionnaire (SPQ). Chi-square tests were applied to compare proportion of moderate or higher AMISOS-R scores over 20 to previously reported values in the extant literature. Next we modelled the quantitative level of AMISOS-R scores as function of AQ-28 with age, sex, and co-occurring disorders. Finally, we ran a mediation model adding SPQ as a mediator. Autistic people reported moderate to extreme levels of AMISOS-R in higher proportion than the general population. In particular autistic females and those with co-occurring disorders scored higher. In quantitative models, we found that autistic traits strongly predicted misophonia symptoms after correcting for multiple covariates. Both the hearing and vision subscales of the SPQ significantly mediated the effect. The increased level of misophonia symptoms in autism and the mediation analyses suggest that autistic traits and sensory sensitivity are factors to consider for a subset of misophonia sufferers, with possible consequences for their clinical interventions.

Serial dependence, the influence of prior experience on current perception or decision, has typically been studied in static, perceptual contexts. Here, we investigate whether serial dependence reflects not just passive carryover but feedback-based updating of internal models, and how this process varies with autistic traits. In an immersive virtual reality penalty-kick task, participants kicked a ball that disappeared mid-flight and estimated its landing position. By laterally displacing the ball upon reappearance, we introduced trial-by-trial prediction errors. We found that individuals with higher autistic traits showed larger prediction deviations, indicating mis-calibrated forward predictions. At the same time, their responses were more strongly shaped by those priors, and unlike lower autistic traits individuals, they did not down-weight reliance when distortions were maximal. This pattern suggests reduced flexibility in updating prediction use: priors were both less accurate and more rigidly applied. Classical stimulus and response history biases were unaffected by autistic traits, highlighting a specific impairment in prediction updating. Football experts, by contrast, combined low directional updating with near-zero prediction consistency, suggesting robust mappings that resist transient perturbations. These findings suggest that serial dependence in dynamic tasks reflects not only prediction formation but the flexible (or rigid) deployment of those predictions in the face of changing feedback. Our results highlight a distinctive rigidity in prediction weighting, rather than a general perceptual bias, in individuals with elevated autistic traits, and reveal contrasting stabilization strategies in domain experts.

Animals may offer vital psychosocial support, particularly for neurodiverse individuals. However, evidence surrounding the effects of pet ownership remains equivocal, especially in relation to cat–human dynamics. This study explored the relationship between cat–human-related factors (CHRFs) and psychological well-being in a sample of 127 adults, including individuals formally diagnosed with autism (30), ADHD (15), and/or co-occurring autism and ADHD (AuADHD; 22). Participants completed measures assessing neurodiverse traits, CHRF engagement, and symptoms of anxiety, depression, and suicidality. Spearman’s correlations analysed the relationships between CHRFs, neurodiverse traits, and well-being. Kruskal–Wallis tests established group differences in well-being and engagement in CHRFs between individuals with and without neurodevelopmental differences. The findings confirmed that autistic and ADHD traits were positively associated with greater anxiety, depression, and suicidality. Autistic individuals reported significantly elevated anxiety and depression; co-occurring diagnoses (AuADHD) were associated with heightened anxiety. Neurodiverse and neurotypical individuals demonstrated similar patterns of CHRF engagement. Several CHRFs, such as anxious cat behaviour, inability to provide for the cat, poor cat health, and close proximity, were linked to negative well-being outcomes. These findings highlight the nuanced, bi-directional nature of cat–human interactions, underscoring the importance of mitigating negative relational factors to support mental health in neurodiverse populations.

Background: Autistic individuals exhibit greater vulnerability to mental health challenges than the general population, yet they lack access to adequate mental health care. Barriers to seeking and receiving adequate mental health care, such as minority stress, adverse life events, discrimination, and stigmatization can result in increased reliance on general and psychiatric emergency departments (ED/PsyED) during mental health crises. There is however limited research detailing PsyED use in autistic adults. Methods: This large-scale retrospective chart review analyzed PsyED visits by autistic adults (aged 16 to 63) in an urban psychiatric hospital in Canada from 2018 to 2020. Data were collected from 345 autistic patients who had 1027 PsyED visits during this 3-year period. Demographic information, psychiatric and neurodevelopmental diagnoses, and reasons for PsyED visits were characterized. Predictors of reasons for visiting PsyED were examined using mixed-effects logistic regressions. Differences between single-time and recurrent visitors were explored. Results: Autistic patients were mostly white (56.2%), Canadian citizens (79.1%), heterosexual (50.7%), and assigned male at birth (72.2%). Many were of low socioeconomic status, with one-third earning less than 15,000 Canadian dollars yearly. Most (84.3%) had at least one co-occurring mental health condition, with 54.8% having two or more. Rates of attention-deficit/hyperactivity disorder and intellectual disability were both around 20%. Most frequent reasons for visits included suicidality (42.9%), aggression (24.6%), and mood symptoms (16.1%). Reasons for visiting PsyED were associated with specific mental health and neurodevelopmental diagnoses. Recurrent visitors (40.3%) did not differ in sociodemographic characteristics from single-time visitors, but had more complex clinical presentations. Conclusion: Mental health needs of autistic adults were high and complex in the PsyED setting, particularly those needing recurrent emergency visits. Addressing service gaps and barriers to ongoing mental health support is essential to enhance the continuity of care.

Background/Objectives: Narrative differences in autism spectrum disorder (ASD) and subtle and parallel differences among their first-degree relatives suggest potential genetic liability to this critical social-communication skill. Effective social-communication relies on coordinating signals across modalities, which is often disrupted in ASD. Therefore, the current study examined the coordination of fundamental skills—gaze and speech—as a potential mechanism underlying narrative and broader pragmatic differences in ASD and their first-degree relatives. Methods: Participants included 35 autistic individuals, 41 non-autistic individuals, 90 parents of autistic individuals, and 34 parents of non-autistic individuals. Participants narrated a wordless picture book presented on an eye-tracker, with gaze and speech simultaneously recorded and subsequently coded. Time series analyses quantified their temporal coordination (i.e., the temporal lead of gaze to speech) and content coordination (i.e., the amount of gaze-speech content correspondence). These metrics were then compared between autistic and non-autistic groups and between parent groups and examined in relation to narrative quality and conversational pragmatic language skills. Results: Autistic individuals showed reduced temporal coordination but increased content coordination relative to non-autistic individuals with no significant differences found between parent groups. In both autistic individuals, and parent groups combined, increased content coordination and reduced temporal coordination were linked to reduced narrative quality and pragmatic language skills, respectively. Conclusions: Reduced temporal and increased content coordination may reflect a localized strategy of labeling items upon visualization. This pattern may indicate more limited visual, linguistic, and cognitive processing and underlie differences in higher-level social-communicative abilities in ASD. To our knowledge, this study is the first to identify multimodal skill coordination as a potential mechanism contributing to higher-level social-communicative differences in ASD and first-degree relatives, implicating mechanism-based interventions to support pragmatic language skills in ASD.

Autistic individuals exhibit altered perceptual and visuomotor behaviors, potentially due to reduced cortical specialization. The current study focuses on handedness, a robust marker of cerebral specialization, which is less right-biased in autism. Previous studies have typically assessed handedness via questionnaires or simple manual tasks that do not characterize the dynamic, on-going nature of real-life actions. To address this gap, autistic and non-autistic right-handed adults recreated LEGO models from blocks placed on a standardized tabletop, enabling analysis of dynamic, real-world visuomotor behaviors. Autistic participants displayed a lower proportion of right-hand grasps and fewer contralateral movements (i.e., crossing the body midline) with their right hand. Additionally, we observed differences in 3D space utilization, such that autistic participants exhibited a stronger preference for blocks placed closer to their hands. Finally, autistic participants were slower, and their movement trajectories were more idiosyncratic when compared with non-autistic participants. These results reveal reduced hand specialization and profound visuomotor control differences in autism, highlighting potential clinical utility for early, objective autism markers.

Purpose Allied health professionals are increasingly using videogames as an intervention modality for certain populations, such as autistic youth. Use of these games may enhance client motivation, while simultaneously providing a more strengths-based and naturalistic environment for skill development. On the other hand, professionals may be concerned about the use of screen-based technologies over real-world experiences. Despite the growing use of video games in support, little research has explored professional perspectives. These insights are crucial for understanding the benefits, challenges, and implementation of games in the support process. Method We conducted a qualitative exploration of professional perspectives on the use of videogames in services for autistic youth. Nineteen professionals from a service provider using videogames as part of their service provision participated in focus groups, with data analyzed thematically. Results Four themes describing professionals’ experiences and perspectives were identified. Overall professionals expressed excitement about the potential of videogames in service provision for autistic youth. However, they also raised several limitations to their use and discussed their responsibilities as clinicians. Conclusion We provide insights that can guide the use and implementation of videogames as part of service provision for autistic youth.

Preliminary studies suggest there are differences in the facial expressions produced by autistic and non-autistic individuals. However, it is unclear what specifically is different, whether such differences remain after controlling for facial morphology and alexithymia, and whether production differences relate to perception differences. Therefore, we (1) comprehensively compared the spatiotemporal and kinematic properties of autistic and non-autistic expressions after controlling these factors, and (2) examined the contribution of production-related variables to emotion perception. We used facial motion capture to record 2448 cued and 2448 spoken expressions of anger, happiness, and sadness from autistic and matched non-autistic adults. Subsequently, we extracted the activation and jerkiness of numerous facial landmarks across time, generating over 265 million datapoints. Participants also completed an emotion recognition task. Autistic participants relied more on the mouth, and less on the eyebrows, to signal anger than their non-autistic peers. For happiness, autistic participants showed a less exaggerated smile that also did not "reach the eyes." For sadness, autistic participants tended to produce a downturned expression by raising their upper lip more than their non-autistic peers. Alexithymia predicted less differentiated angry and happy expressions. For non-autistic individuals, those who produced more precise spoken expressions had greater emotion recognition accuracy. No production-related factors contributed to autistic emotion recognition. This mismatch could explain why autistic people find it difficult to recognize non-autistic expressions, and vice versa; autistic and non-autistic faces may be essentially "speaking a different language" when conveying emotion.

Cross-sectional research documents atypical age-related development of white matter in autism spectrum disorder (ASD). However, little is known about the developmental changes in white matter microstructural properties in ASD. This study aims to investigate developmental changes in white matter tract microstructural properties in ASD using a longitudinal follow-up design and normative model analysis, and to examine clinical correlates of these changes. We assessed 75 autistic individuals (aged 15.3 ± 4.2 years) with diffusion spectrum imaging at baseline and 4.7 ± 1.9 years later. To measure the magnitude of deviation from the norm, we calculated z-scores for fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) for each of 76 tracts based on a norm established in 680 typically developing individuals. Callosal fibers connecting the temporal poles, hippocampus, and amygdala in ASD individuals showed higher AD, RD, and MD at both time points. Several tracts showed significantly greater increases in FA z-scores from baseline to follow-up, including the right superior longitudinal fasciculus, precentral thalamic radiation, frontal aslant tract, right corticospinal tracts, left arcuate fasciculus, callosal fibers connecting genu, and bilateral thalamic radiation, implying a pattern of greater deviation from the norm at Time 2 than Time 1. Higher autistic severity or social deficits at baseline were related to greater increasing rates in the diffusion metrics of callosal fibers connecting the precuneus (AD, RD, and MD), corticospinal tract (AD), right geniculate fibers (AD and MD), and right medial lemniscus (AD and MD) from baseline to follow-up. Using the normative model method to analyze longitudinal data on white matter microstructures, our findings support persistent alterations in callosal fibers and developmental alterations of several tracts in ASD, which were associated with baseline autistic severity.

The global prevalence of Autism Spectrum Condition (ASC) is increasing, yet effective supportive interventions remain largely unidentified, highlighting the urgent need to clarify the underlying neuropathophysiology. Neuroimaging offers a pathway toward this understanding; however, most studies rely on indirect measures of neurophysiology, whereas direct approaches such as [18F]Fluorodeoxyglucose positron emission tomography (FDG-PET) remain underutilized and lack systematic synthesis in the literature.This review and meta-analysis evaluated FDG-PET research in ASC. A systematic search identified 2,725 records, of which 21 studies compared FDG-PET findings between autistic and neurotypical individuals. Nine met the inclusion criteria for the review, and eight were included in the meta-analysis.The review revealed inconsistent findings, reporting both increased and decreased glucose metabolism in ASC, likely reflecting methodological heterogeneity. The meta-analysis found no statistically significant differences, but indicated a weak non-significant trend toward elevated glucose metabolism in the striatum in autistic compared to neurotypicals individuals (standardized mean difference [SMD] = 0.416; 95% CI - 0.200 to 1.032; p = 0.186).Despite 40 years of FDG-PET research in ASC, the number of studies remains limited, and several exhibit methodological shortcomings. Evidence from FDG-PET studies in other psychiatric and neurological disorders underscores the technique's potential value in ASC research. The findings of this study further emphasize the urgent need for rigorously designed investigations to clarify the relationship between cerebral glucose metabolism and autism, with the ultimate goal of advancing our understanding of the autistic brain.

Psychological assessments play a significant role in both clinical decision-making and the interpretation of research findings, with the quality of these inferences depending on the validity of the measures used. Recent evidence suggests there are gender differences in the presentation of autism, raising concerns about the validity of existing autism tools to measure autistic traits in women and the subsequent implications for clinical inferences and research. This study explored the perspectives of autistic women on the relevance of existing autism questionnaires to their lived experience, alongside additional input from gender-diverse individuals assigned female at birth (AFAB). Through interviews, focus groups, and online surveys, 22 autistic women and AFAB gender-diverse individuals shared their experiences using and perspectives on the Autism Spectrum Quotient-10, 14-item Ritvo Autism & Asperger Diagnostic Scale, and Broad Autism Phenotype Questionnaire. The interview data were analysed using reflexive thematic analysis, identifying two overarching themes: (1) questionnaires measure only one way to be autistic, and not in an autism-friendly manner, and (2) enhancing questionnaires’ relevance for autistic women and individuals socialised as female: key missing experiences to include. The findings suggest that some of the most frequently used autism measures may not fully capture the experiences of autistic women and AFAB gender diverse individuals. Significant gaps were identified, indicating that important aspects of the participants’ lived experiences were missing. Furthermore, concerns were raised about the questionnaires’ lack of relevance to the autistic population as a whole. The findings underscore the non-satisfactory content validity of these tools for measuring autism in autistic women and AFAB gender-diverse individuals. This highlights the need for their refinement to better reflect contemporary understandings of different presentations of autistic traits, particularly the impact of gendered experiences, in a way that avoids the introduction of possible new biases and remains relevant and accessible to autistic individuals.

ABSTRACT Autistic masking has emerged as a pivotal topic of contemporary debate, highlighting the concealment of one's authentic self – a process that often leads to inauthenticity. While the negative impacts of masking are widely acknowledged, the nuanced role of inauthenticity within this phenomenon, particularly its dialectical relationship with authenticity, remains underexplored. In this article, I build on empirical work published by scholars in Psychology, Sociology, Psychiatry, and other fields to argue that, informed by Heidegger's philosophical insights, the act of masking – an attempt to blend in with non‐autistic individuals – can paradoxically facilitate the growth of the authentic self. Rather than viewing the authentic and inauthentic selves as opposing forces, I propose that they coexist in a dynamic interplay for individuals with autism. The autistic self does not exist as an isolated ‘I’ in authenticity. Instead, autistic individuals can only experience their authentic selves through social interactions with others. Furthermore, Heidegger's concepts illuminate how autistic individuals often grapple with anxiety and feelings of uncanniness in interactions with non‐autistic peers; these existential moods can drive them toward a more genuine self‐expression. Consequently, navigating the delicate balance between their authentic and inauthentic selves becomes essential during social interactions. Equally important is the role of non‐autistic individuals in cultivating inclusive attitudes and supportive environments that enable diverse behavioral expressions and interaction styles within mixed neurotypical relationships.